Fallopian tube removal is an operation that is performed on many women at different ages. Sometimes doctors have to cut out one, and sometimes two tubes at once. Statistics indicate that from 3 to 12% of women go through the procedure of removing appendages.

The general condition of the body, according to some experts, is not disturbed, because the fallopian tubes are only a transport system for eggs and sperm.

However, there are a number of scientific works that prove the opposite point of view. The authors point out that irregularities in the menstrual cycle, hormonal imbalances and other problems with the female reproductive system most often occur in those patients who have had their fallopian tubes removed.

Salpingectomy is a surgical procedure whose purpose is to remove the fallopian tube. Another name for the procedure is tubectomy. During this procedure, one or both appendages are removed. The procedure can be performed for vital indications on an emergency basis. If the patient’s life is not in danger, then tubectomy is planned.

Indications for salpingectomy:

Growth and development of the embryo in the cavity of the tube. As an emergency, the procedure is performed when the embryo ruptures the appendage and the woman’s internal organ opens.

If an ectopic pregnancy forms in the same tube for the second time.

Pelvic adhesions that grow into tubes.

Ectopic pregnancy that is not subject to conservative therapy (when the diameter of the ovum exceeds 30 mm). As for the conservative method of treating ectopic pregnancy, it is implemented with the goal that the woman will be able to become pregnant on her own in the future. In this case, the fertilized egg is pushed into the ampullary part of the tube, or a salpingostomy is placed on it.

The tube can be removed if the salpingostomy was unsuccessful and was complicated by bleeding.

In case of severe deformations of the fallopian tube due to or salpingitis. The pipe is removed when its functionality cannot be restored.

Formation of pyosalpinx (accumulation of pus in the lumen of one or both fallopian tubes).

Planning for in vitro fertilization. Doctors in some cases insist on removing the fallopian tubes, citing the fact that IVF may be ineffective. The fact is that a reverse flow of inflammatory exudate from the tubes into the uterine cavity and “washing out” of the implanted but not implanted fertilized egg is possible. In addition, if an inflammatory process occurs in the tubes, this can lead to a toxic effect on the embryo. Sometimes it happens that the implanted embryo begins to take root in the uterus, but after some time, due to inflammation in the tubes, the woman has a miscarriage. Therefore, if a patient has had hydrosalpinx for six months and is planning IVF, then doctors insist on preliminary removal of the fallopian tubes.

The presence of hydrosalpinx in itself, without planning IVF, may be an indication for removal of the fallopian tube. This is especially true for those patients whose hydrosalpinx is of impressive size.

A combination of hysterectomy is possible (the operation is used for pathologies of the uterus, malignant neoplasms of the ovaries, etc.) and tubectomy.

Most often, the doctor decides on the possibility of removing or preserving the fallopian tubes after or during diagnostic laparoscopy.

How fallopian tubes are removed: the essence of the procedure

There are two types of tubal removal surgeries: laparoscopy and laparotomy. Laparoscopic intervention is a priority; it has a minimal set of contraindications, does not require extensive incisions to gain access to the fallopian tubes, and does not injure tissues and organs. In addition, patients recover quite quickly after it, and the rehabilitation period itself is much easier than after laparotomy.

If a tube ruptures due to an ectopic pregnancy, this process is almost always accompanied by severe bleeding. The development of hemorrhagic shock and other complications, even death, cannot be ruled out. Therefore, in such a situation, a woman can only undergo laparotomy. In parallel, intensive infusion and transfusion therapy will be carried out. Only through emergency surgery can the woman’s life be saved.

Stages of laparotomy:

Introduction of general anesthesia.

Making an incision: according to Pfannenstiel (a transverse incision above the pubis) or an incision in the anterior wall of the peritoneum, below the umbilical zone.

Pumping out blood that has entered the abdominal cavity. The blood is collected in separate bottles so that it can be transfused in the future. However, autologous blood transfusion is only available if the patient does not have inflammation.

Removal of the uterus and appendages to detect the source of bleeding.

Applying a clamp to the isthmic part of the appendage, as well as to the mesentery. This helps stop the bleeding.

Cutting off the fallopian tube.

Sanitation of the peritoneum and suturing.

When performing laparoscopy, the surgeon performs similar actions, but the blood pumped out from the peritoneum is not transfused to the woman.

If possible, the pipes are not completely removed, but partially.

Indications for tubal resection:

The presence of adhesions only in a small area of ​​the fallopian tube.

An ectopic pregnancy that has just begun to develop.

A benign tumor in one of the corners of the uterus.

The decision as to whether it is possible to remove only part of the fallopian tube is made on an individual basis.

Contraindications to tubal laparoscopy

The fallopian tubes cannot be removed using the laparoscopic method if there are the following contraindications:

Peritonitis.

Rupture of the fallopian tube, accompanied by severe bleeding.

Nervousness, irritability, tearfulness;

Painful sensations in the heart area;

Increased sweating;

Rush of blood to the upper half of the body.

Symptoms tend to intensify before the next menstruation, and they do not bother all women (observed in approximately 42% of cases).

About 35% of patients notice menstrual irregularities 2-3 months after removal of the appendage. During an ultrasound, they are diagnosed with an enlarged ovary on the side where the fallopian tube was removed. Over time, it undergoes sclerotic changes, which is caused by disruption of the flow of lymph and blood.

There is also an alternation of normal menstrual cycles with disrupted ones. There may be a decrease in the performance of the luteal body and cessation of ovulation. However, such conditions are rarely observed.

The following changes occur in the mammary glands:

The glands become rough in 6% of patients;

The breasts become larger due to diffuse expansion of the lobules in 15% of patients;

The thyroid gland increases in size and its functioning is disrupted in 26% of patients;

The following symptoms may also develop: excess weight gain, the appearance of body hair, and the formation of stretch marks on the skin.

These symptoms are especially pronounced in those women who have undergone surgery to remove both appendages.

In the early rehabilitation period, the woman is advised to administer antibiotics, which helps prevent the development of possible inflammation.

To minimize the risk of adhesions forming, the following measures are taken:

Doctors try, whenever possible, to use laparoscopic surgery, which is minimally traumatic.

Before completion of the operation, barrier absorbable gels are injected into the abdominal cavity. For some time they contribute to the fact that the surfaces of the organs are located at a distance from each other. This is a measure aimed at preventing adhesions.

After the operation, the patient is raised the next day.

The woman is prescribed physiotherapeutic procedures: electrophoresis with iodine and zinc.

Calm walking and other moderate loads can prevent the formation of adhesions, or reduce the risk of their formation to a minimum.

After the operation, the woman is prescribed a course of antibiotics and given subcutaneous injections of aloe extract for 14 days. It is possible to prescribe Longidaza vaginal suppositories.

For 6 months after removal of the fallopian tubes, it is mandatory to take contraceptives to prevent pregnancy.

It is important to properly care for postoperative sutures, which will prevent their inflammation. You should avoid taking a bath and wash in the shower. In this case, the seams must be closed to prevent water from getting into them.

For a month after surgery, doctors recommend that patients wear slimming underwear.

Intimacy is absolutely prohibited during the first month after surgery.

You do not need to adhere to any special diet. However, you should temporarily exclude from your menu foods that increase gas formation in the intestines. Therefore, you need to give up legumes, whole milk, yeast baked goods and pastries, cereals, meat and carbonated drinks.

After the operation, a woman may experience bleeding from the vagina for several days. This is a normal phenomenon, especially when a pipe has ruptured or a hematosalpinx has been removed. Bloody discharge should not be considered as a complication of the operation, since it is explained by the reflux of blood into the uterus during surgery or before it begins.

If the body quickly adapts, or a hormonal imbalance occurs due to an existing disease, then a few days after the removal of the appendages, the woman may begin her next menstruation. Moreover, this cycle may be longer than all previous ones. If there is minor blood loss characteristic of standard menstrual bleeding, you should not worry about this. If the blood loss is significant, then uterine curettage and blood transfusion may be required.

Early onset of menstruation after surgery is rare; in the vast majority of cases, menstruation comes on time. Although sometimes it happens that the cycle is restored for at least two months. This is also not a deviation from the norm. If 60 days after the operation the cycle has not stabilized, then you need to contact a doctor. It is possible that the operation resulted in endocrine disorders that require professional correction.

Is it possible to get pregnant without fallopian tubes?

Without fallopian tubes, a woman cannot become pregnant naturally. To date, doctors have not been able to develop an analogue of the fallopian tubes, although they have been trying to make them for many years. The first attempt to implant artificial appendages was made back in the 70s of the last century. However, it was not successful, so it did not take root in medicine.

The only method that can help women without both fallopian tubes conceive and carry a child to term is in vitro fertilization.

If there is no fallopian tube, where does the egg go?

When both fallopian tubes are in place, they use fimbriae to capture the egg released from the ovary into the abdominal cavity and gradually move it into the uterus. It is also possible for a sperm to meet an egg in the tube and fertilize it. In the peritoneal cavity, the egg can exist for two days, after which it dies.

When a woman has one tube missing, the following options are possible:

Ovulation will not occur, the follicles will begin their reverse development. This situation is most often observed against the background of hormonal imbalance.

The egg will be released into the abdominal cavity, and after 2 days it will die and be destroyed in it.

The egg will float around the abdominal cavity, can reach the tube that remains intact, and pass through it to the uterus.

Of course, it is much easier for fimbriae to capture the egg that is released by the ovary from the side of the healthy tube. If a woman has both appendages removed, the ovaries either undergo reverse development, or the egg will constantly die in the peritoneal cavity.

When can you plan to conceive after surgery?

After removal of one fallopian tube, a woman will be able to become pregnant on her own in 56-61% of cases. Moreover, this does not depend on the type of surgical intervention. Doctors indicate that you need to plan a pregnancy no earlier than six months after the operation. A number of experts recommend that a woman wait 1-2 years while taking oral contraceptives. During this time, it will be possible to normalize the functioning of the neuroendocrine system and the body will be ready to bear a child.

After removal of the fallopian tubes, 42% of patients develop infertility, and in 40% of cases, the ovaries stop working with their previous strength. Moreover, the risk of developing an ectopic pregnancy increases 10 times. Therefore, IVF is the only method that allows a woman to conceive a child after removal of the fallopian tubes.

Can tubal plastic surgery replace them?

Gynecologic surgeons may perform surgery to repair part of the fallopian tube, calling the procedure a fallopian tubeplasty. It is carried out after removal of the deformed area of ​​the appendage.

As for the complete restoration of the fallopian tubes, this operation is not advisable. The fact is that a woman’s own appendages have the ability to contract so that the egg can move through them and reach the uterus. After plastic surgery, the tubes lose their ability to contract, which means fertilization will be impossible. Therefore, the operation is performed only when a small section of the appendage needs to be replaced.

Education: Diploma in Obstetrics and Gynecology received from the Russian State Medical University of the Federal Agency for Health and Social Development (2010). In 2013, she completed her postgraduate studies at NIMU named after. N.I. Pirogova.

Is it possible to get pregnant without fallopian tubes naturally, if both or one ovary is removed and is it possible to get pregnant if the fallopian tubes are ligated - read the answers from medical professionals.

Answer:

The fallopian tubes are a kind of life path in a woman’s body. They are two thread channels that have an average length of 10-12 cm and a diameter of 5 mm. The inner wall of the tubes is covered with villi, which serve to move the egg during ovulation. The main task of these organs is to achieve pregnancy.

In some cases, they may become damaged or removed, causing significant difficulties. The woman herself will not feel their lack, but achieving fertilization naturally is impossible. But is it possible to get pregnant without tubes? Yes, it's possible. For this purpose, a special procedure is used - in vitro fertilization. It is recommended for all women with this problem, and successful fertilization is achieved in three out of five cases.

Like the fallopian tubes, the ovaries can be removed, thereby reducing the risk of successful fertilization. Without two ovaries at once, pregnancy is impossible. If at least one functioning organ remains, then conception can occur. During removal, doctors evaluate the condition of both ovaries and fallopian tubes so that, together, one functioning organ can allow the woman to have children. If one of them works poorly, the chance of a natural pregnancy tends to zero.

Is it possible to get pregnant after an ectopic pregnancy?

Ectopic pregnancy is one of the most terrible diagnoses during pregnancy. If the disease is not detected in time, serious complications may develop, including death. Treatment for such a diagnosis is very painful and leaves a serious psychological impact.

After an operation to eliminate the pathology, many women do not dare to have a child again for a long time because they are afraid of a repetition of the situation. The question may also arise: is it possible to get pregnant after an ectopic pregnancy? According to doctors, such a diagnosis can significantly reduce the chance of successful fertilization. But despite this, subsequent pregnancy is possible, regardless of location.

First of all, it is necessary to undergo a rehabilitation course that will allow the pipes to recover. Intimate relationships are contraindicated in the first month, and the minimum period for full recovery is six months. Afterwards, you need to consult a doctor who will determine the condition of the body and the possibility of further fertilization. For this purpose, perturbation and laparoscopy are used. They also allow you to clean the tubes so that the egg can successfully enter the uterus and prevent the possibility of recurrence of the pathology.

Is it possible to get pregnant if the fallopian tubes are blocked or if they are ligated?

Many women have problems with the patency of the fallopian tubes, which can cause a huge number of serious consequences. The most dangerous is ectopic pregnancy, which is treated with surgery and does not allow pregnancy for some time. Another factor may be the inability to ovulate correctly, which is why the girl is unable to have children.

Today, medicine is able to correct this situation. The use of hysterosalpingography, perturbation and laparoscopy makes it possible to clean the tubes and give a chance for successful fertilization naturally. In special cases, when the situation is too complicated and it is not possible to conceive a child, IVF is used, which itself delivers the egg to the right place and fertilizes it. This operation requires careful planning for the possible occurrence of ovulation.

Some women deprive themselves of the opportunity to have children by tying their tubes. But, is it possible to get pregnant if the fallopian tubes are tied? This operation gives a 100% result of infertility, and exceptional cases occur only for three reasons.

In case of an incorrectly performed operation. Poor quality work can give the egg the opportunity to enter the uterus and be fertilized. The second situation is the fusion of both threads, thereby creating a new path to fertilization. The last case is the possibility that pregnancy already occurred during the operation.

Hello, Olesya!

The fallopian tubes in a woman’s body perform a very important function; it is through the fallopian tubes that the egg moves when the follicle bursts; during the period of ovulation in a woman, the egg goes straight into the fallopian tube, and moreover, fertilization of the egg most often occurs in the fallopian tube.
Sperm also move towards the egg through the fallopian tube; if the egg and sperm meet, fertilization occurs. Impaired functionality of the fallopian tubes can cause infertility. For example, as a result of some inflammatory diseases of the uterus, adhesions may develop in the fallopian tubes; in this situation, there is a high risk of developing either infertility or an ectopic pregnancy.
In addition, quite often the reason for removal of the fallopian tubes is an ectopic or “tubal” pregnancy. A woman’s ovaries ovulate alternately, that is, in one cycle, for example, ovulation occurs in the right ovary, and in another cycle in the left. When one fallopian tube is removed, a woman has a chance of getting pregnant naturally, but they are significantly reduced when both fallopian tubes are removed. tubes, the chances of getting pregnant naturally are practically zero.
Pregnancy is impossible due to the fact that the egg and sperm cannot meet; the egg cannot enter the fallopian tube during ovulation, because it simply does not exist, the sperm cannot reach the egg and fertilize it.
Removal of the fallopian tubes is a last resort and is sufficiently used for women of reproductive age who do not have children, but nevertheless, if such a procedure was performed, then pregnancy is possible only with the help of Extra Coronal Fertilization or, in other words, IVF.
Tubal ligation is also used in gynecology as a means of contraception; in some cases, the procedure may not be effective enough for certain reasons, for example, in this case, the likelihood of pregnancy in a natural way still remains.
Preservation of the fallopian tubes and their integrity is quite an important fact when planning pregnancy, if the patency of the fallopian tubes is impaired, if the fallopian tubes are missing partially or completely, then the question of pregnancy can be called into question, if the woman’s fallopian tubes are removed, She is automatically diagnosed with infertility, and this kind of infertility cannot be treated with medication or surgery.

If, if the integrity of the fallopian tubes is violated, theoretically, the chance of pregnancy in a natural way, after adequate treatment, still remains, then in the absence of fallopian tubes, a woman has a chance of pregnancy only after IVF.
The level of modern medicine is quite high, but despite this, if a woman does not have fallopian tubes, pregnancy in a natural way is definitely considered impossible. Depending on your preferences, you can contact the gynecologist and ask to be registered for infertility and on the waiting list for the IVF procedure. , or give preference to surrogacy.

Best regards, Veronica.

The fallopian tubes, also known as the oviducts, are two thin long processes that extend from the uterus on both sides and reach the left and right ovaries. Together with the ovaries, the tubes make up the appendages of the uterus, and when they become inflamed, the diseases are called salpingitis (tubes), oophoritis (ovaries), (salpingoophoritis, adnexitis), hydrosalpinx.

The role of the fallopian tubes in conception

In one of the ovaries, every month in a healthy woman, a dominant follicle matures; during ovulation, approximately in the middle of the cycle, when the follicle ruptures, an egg is released, giving rise to a future pregnancy. From the ovary, the egg must enter the fallopian tubes and move along them towards the uterus. At this time, sperm from the vagina rush through the cervix, the uterus itself to the fallopian tubes towards the egg, where they must fertilize it.

After this, the egg becomes an embryo and continues its journey through the tubes to the uterus, this period is usually 7-10 days. If fertilization fails, the egg dies and is resorbed within 24 hours. Therefore, the fallopian tubes play the most important role as transporters that deliver the egg to the uterus.

The length of the fallopian tubes is almost 10 cm, and the diameter is only 1 cm, and the internal canal of each tube is only from 0.1 cm to 1 cm (narrow at the entrance to the uterus, wider at the ends of the tube). However, this is quite enough for microscopic eggs and sperm to move freely in them.

What is the danger of fallopian tube obstruction?

In cases where both or one tube is blocked, inactive, rigid, or the mobility and function of the cilia (villi, fimbriae) that direct the egg into the fallopian tube is impaired, pregnancy cannot occur. Tubal obstruction does not pose a threat to a woman’s health, but is one of the most serious problems with conception and the cause of tubal infertility.

Today, clinical data states that 15% of married couples face the problem of infertility due to the woman’s fault, and 20-25% of this number is due to problems with the patency of the fallopian tubes. Moreover, with various deviations, dysfunctions of the uterine appendages, with partial blockage of the tubes or an inflammatory process in the appendages, it is very dangerous, which can deprive a woman of one of the fallopian tubes.

The main causes of obstruction of the fallopian tubes

It should be noted right away that the concept of obstruction includes several pathological conditions:

• Complete obstruction of the pipes
• One impassable pipe
• Adhesions around the uterine appendages
• Partial obstruction - since the movement of the egg occurs due to contraction of the tube, in various pathological conditions its contraction is disrupted and the transportation of the fertilized egg becomes difficult, sometimes leading to ectopic pregnancy
• Violation of the activity of villi, fimbriae, which are not able to capture the egg and direct it into the fallopian tubes

Obstruction can occur either when a narrow channel inside the pipe is blocked, or during an adhesive process due to squeezing the pipe from the outside. The main causes of fallopian tube obstruction are as follows:

Inflammatory diseases of the uterine appendages

Any inflammation of the uterine appendages can occur both acutely and latently, with few symptoms, especially with such hidden sexually transmitted infections as ureaplasmosis, mycoplasmosis, cytomegalovirus infection, etc. In acute processes, treatment is carried out in the hospital with antimicrobial, anti-inflammatory drugs, then a long course of recovery is carried out , resorption therapy. But with hidden infections, the process is not noticeable. During the proliferation of bacteria, their waste products, mucus, and pus fill the narrow passages in the fallopian tubes. If timely treatment and resorption therapy are not carried out, adhesions and scars remain on the thin sensitive walls, which leads to partial or complete obstruction.

Tuberculosis of female genital organs

Many sources of medical literature indicate that tuberculosis very rarely affects the genitals and is considered an uncommon cause of infertility. However, today the decline in the level of health of the nation, the decline in immunity among the population, as well as the resistance of Mycobacterium tuberculosis to drugs leads to the fact that many chronic patients who cannot be treated, as well as unexamined citizens, live in cities. Infection and morbidity among children is becoming very high. And almost the entire population becomes infected with Koch's bacillus before the age of 15-20, and the disease can manifest itself years or decades after infection.

It should be borne in mind that the insidiousness of this disease is that it affects not only the lungs, but also any organs of the human body and is asymptomatic; moreover, extrapulmonary forms are extremely difficult to diagnose. When a girl is infected during the period of growth and formation of the genital organs, tuberculosis can lead to abnormalities in the development of the uterus and appendages, hormonal imbalance, underdevelopment of the mammary glands (hypomastia), complete obstruction of the fallopian tubes, and impaired ovarian function.

The insidiousness of this infection also lies in the fact that after infection, the immune system copes with the mycobacterium and the foci of inflammation subside on their own. And with a decrease in immunity, with severe exhaustion, excessive dieting, severe stress, during puberty or hormonal changes, very often after childbirth, a relapse may occur again. Moreover, an X-ray of the lungs in a girl or women may be normal.

In Russia today, medicine turns a blind eye to the existing problem of the epidemic of tuberculosis and its drug-resistant forms. Diagnosis of extrapulmonary forms of the disease is at an extremely low level, but many women could successfully become pregnant if tuberculosis was detected in time and treated properly.

Anti-tuberculosis services in the regions of the country are very limited in funding and even when a person applies for diagnostics, except for mantoux, diaskintest, and x-rays (excluding only pulmonary tuberculosis), no thorough diagnostics are carried out in cities far from Moscow and St. Petersburg, not There are enough qualified TB gynecologists. But tuberculosis of the female genital organs is often latent and sluggish, sometimes giving false negative culture results (1 positive out of 3 negative).

If a woman constantly (or periodically in the second phase of the menstrual cycle) has a subfebrile body temperature of 37-37.5, weakness, allergic reactions, increased sweating, chronic salpingitis or salpingoophoritis, tests for hidden infections give negative results, persistent infertility due to uterine obstruction tubes, it is also possible that there is hypoplasia of the uterus (“baby uterus”) and the treatment is ineffective; the doctor should recommend being examined in the anti-tuberculosis gynecological department (preferably in St. Petersburg or Moscow) to exclude or confirm tuberculosis of the female genital organs.

Other reasons

• Operations in the abdominal cavity or pelvic organs - removal of appendicitis if it ruptures, intestinal surgery, abdominal trauma, peritonitis, adhesions formed after any surgical intervention in the abdominal cavity
• Endometriosis
• ), intrauterine manipulation, hydrotubation of the fallopian tubes
• Past ectopic pregnancy
• Congenital malformations of the fallopian tubes
• Fallopian tube tumors or polyps

The risk of developing fallopian tube obstruction due to inflammation, according to clinical observations, is:

• After 1 episode of inflammatory process in the uterine appendages, the risk of fallopian tube pathology is 12%
• After 2 episodes – 35%
• After the 3rd inflammatory process - 75%

If a woman experiences acute, aggressive inflammation of the uterine appendages, it may be necessary to remove both or one fallopian tube and, of course, pregnancy naturally becomes unlikely or impossible. How to treat tubal obstruction? Today, such a progressive trend in reproductive medicine as IVF gives all women a chance to experience the joy of motherhood even in the absence of fallopian tubes.

Symptoms, signs of tubal obstruction

If the fallopian tubes are obstructed, there may be no symptoms or signs; this pathology may not affect the general state of health and well-being in any way. There are cases when a young woman is protected in order not to become pregnant during periods of life when they are not planning to have children, and when the desire to have a child comes, the absence of pregnancy and the diagnosis indicated serious problems with the fallopian tubes.

This happens, unfortunately, not rarely. The woman did not even know about such a pathology, because there were no symptoms of obstruction of the fallopian tubes and no serious health problems either. However, with chronic recurrent inflammatory diseases, as well as with hydrosalpinx, many women experience the following signs of tubal obstruction, which can occur with other pathological processes of the female genital organs:

How to determine, how to check for obstruction of the fallopian tubes - diagnostics, examinations

• To begin with, it is determined whether a woman has regular ovulation - a regular ultrasound or transvaginal (with a vaginal sensor); a woman can also measure basal temperature over several cycles on her own
• Then the sexual partner should undergo a semen analysis

If a man’s spermogram is normal, and a woman has regular ovulation, a normal structure of the genital organs, and no signs of inflammation, the most likely cause of infertility is obstruction of the fallopian tubes. In this case, additional instrumental diagnostic methods are indicated.

Hydrosonography (echohysterosalpingoscopy) or ultrasound determination of fallopian tube patency

It is clear that conventional transvaginal ultrasound cannot determine the patency of the tubes. But a special UZGSS can give a general conclusion about whether the pipes are passable or not. The disadvantage of this diagnosis is that it is not an accurate method, unlike diagnostic laparoscopy or HSG. However, this is a very fast and low-traumatic method that does not require anesthesia, surgery (as with laparoscopy), or radiation exposure (HSG), so the study is safe and can be performed several times.

Hydrosonography occurs in this way - before the procedure, the doctor injects a sterile physiological or other solution into the uterine cavity in order to straighten the walls of the uterus and make them more visible on ultrasound. After this, the doctor determines where the injected fluid flows. With tubal patency, fluid flows from the uterine cavity into the tubes, and then into the abdominal cavity, and a specialist can see this using an ultrasound. If the fallopian tubes are obstructed, the uterus will stretch and its cavity will expand. However, in case of partial obstruction, adhesions, or other pathologies, it is impossible to clearly see the picture of the condition of the pipe using this method.

HSG – hysterosalpingography, x-ray of the uterus and tubes

This method of checking the patency of pipes is more informative than hydrosonography, but in recent years it has been used much less frequently than before. For diagnosing tuberculosis of the female genital organs, this method is the most informative. The essence of the procedure is as follows: after local anesthesia, the doctor injects a contrast agent into the uterine cavity and takes several x-rays after a certain time.

The images will show clear outlines of the uterus, then as the fluid moves through the tubes, the fallopian tubes will be visible, as well as the flow of fluid into the abdominal cavity when the tubes are patency. If the fluid stops in any part of the pipe, the doctor can record its obstruction. This procedure should be carried out in phase 1 of the menstrual cycle to avoid irradiation of the egg.

Many doctors find this method to be somewhat therapeutic, since the injected solution has a flushing effect. However, today this diagnostic method has begun to be used less frequently due to the fact that this procedure should only be performed by an experienced doctor, and it does not always bring reliable results (in 15-20% of cases there may be false results) when, due to a spasm of the tube, the contrast the substance does not enter the pipes.

Diagnostic laparoscopy

Today this is one of the most popular, informative, accurate methods of not only diagnosing, but also treating female infertility. With this method, not only tubal obstruction and signs of fallopian tube obstruction are detected, but also other causes of infertility, such as endometriosis, ovarian cysts, polycystic ovary syndrome, etc. The advantage of this method is the accuracy of the results and the ability to eliminate some disorders - adhesions are cut, lesions are cauterized endometriosis. In order to determine if the fallopian tubes are blocked through the cervix, the doctor injects a solution that penetrates the tubes and then into the abdominal cavity.

Fertiloscopy and transvaginal hydrolaparoscopy

Transvaginal hydrolaparoscopy is an examination of the condition of the female genital organs using a video camera, as with laparoscopy, only through a small incision in the vagina. Often this procedure is performed together with chromohydroturbation and salpingoscopy, then this study is called fertiloscopy. To determine the causes of infertility, both fertiloscopy and transvaginal hydrolaparoscopy are as effective as conventional laparoscopy, only they are less traumatic and do not cause complications.

How to treat tubal obstruction

All of the listed methods for diagnosing tubal patency can be erroneous, not 100%, so do not despair, a woman always has a chance of becoming pregnant if she has a uterus and at least one tube and an ovary. You can use modern methods of anti-inflammatory, absorbable therapy, as well as laparoscopy and IVF.

Tubal obstruction causes only 25% of all cases of infertility; in all other situations, the inability to conceive is caused by endometriosis, ovarian dysfunction, immunological incompatibility of partners (that is, a woman’s allergy to her husband’s sperm), as well as pathological disorders in the man’s body, or simultaneous problems in both partners.

When tubal obstruction is determined, before starting any treatment, the attending physician must make sure that this is the only main cause of problems with conception, and not a complex of other disorders in the woman and her man. A standard comprehensive examination of a married couple is as follows:

• Does a woman ovulate regularly?
• Determining a woman's hormonal balance
• Condition of the uterine mucosa
• Husband's sperm quality analysis - )

If it is determined that the woman produces follicles regularly, the menstrual cycle is not disrupted, the hormonal levels are also normal, the uterus is able to support the development of the fetus, the man has normal sperm quality, and instrumental methods diagnose obstruction, then experts can recommend conservative and surgical treatment.

• Conservative is a course of anti-inflammatory therapy when an inflammatory process of the uterine appendages is detected. It consists of: a course of antibiotic injections, a course of Longidase injections, physiotherapy (and improving local blood circulation). This will be effective if treatment is carried out no later than 6 months after adnexitis and when a pronounced adhesive process has not yet developed.
• Surgical treatment to restore tubal patency is indicated for women under 35 years of age with regular ovulation in cases of partial obstruction.

And even such serious measures cannot guarantee success, since there is a high probability of developing an ectopic pregnancy, and restoration of tubal patency may not be enough if the activity of the fimbriae is impaired, or if the contraction of the fallopian tubes is impaired.

A woman after tubal surgery in the future, if the pregnancy test is positive, should immediately consult a doctor to find out the location of the fertilized egg. Because after inflammatory processes and surgery, the risk of ectopic pregnancy increases 5-10 times.

In cases where several types of different diagnostics confirm complete obstruction, a woman who wants to have children should not waste time on various types of treatment for obstruction of the fallopian tubes, but prepare for IVF. Today, this procedure is becoming more and more accessible both in terms of price (no more than 150 thousand rubles with all tests and diagnostics), and in terms of a large number of accessible centers with experienced specialists and equipment for performing the operation. In doubtful cases or when the patency is impaired in one of the pipes, laparoscopy may be used to eliminate, if possible, existing disorders, obstructions and adhesions.

In themselves, such operations do not guarantee either conception or the normal course of pregnancy, since the presence of a lumen does not mean at all that the egg will be able to move through them. Therefore, it is important to carry out further physiotherapeutic, absorbable treatment, as well as eliminate possible menstrual cycle and hormonal disorders.

In case of infertility due to obstruction of the fallopian tubes, the choice of treatment also depends on the age of the spouses, the degree of damage to the tubes, additional factors of infertility of the man and woman, as well as the financial capabilities of the couple. Nevertheless, IVF is recognized today as the most effective, not very expensive and more successful, reliable method:

Fallopian tube obstruction - folk remedies

What is the use of all folk remedies for the treatment of obstruction of the fallopian tubes - the use of herbal remedies, medicinal plants in the form of tampons, douching, ingestion of infusions and tinctures. A woman must understand that if the fallopian tubes are blocked, such methods are unlikely to be effective, and precious time will be lost.

For example, you cannot use such a medicinal plant for tubal obstruction (see), since the likelihood of ectopic pregnancy increases, although for infertility for other reasons it is recommended as a folk remedy.

And such a method as douching is recognized by gynecologists as a rather unsafe means of self-medication, which is fraught with the development of vaginal dysbiosis, increasing the risk of developing inflammatory diseases of the genital organs and the risk of damage to the vagina, bladder, and cervix. (cm.).

Any medicinal herbs are the same medicines as pharmaceutical drugs, with possible toxic effects, side effects and contraindications, moreover, in our age of abundance of allergic diseases, in the presence of bronchial asthma, herbal preparations can cause severe allergic reactions.

As long as I have at least some chance to give birth, I will go to the end! In the end, there is only one pipe left, if something happens, then for the last time there will be nothing more to remove

Twentieth story as part of the competition "My Infertility Story"

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My story is the other way around

We met my future husband 2 years before our relationship was formalized. We spent a year preparing for the wedding, and this day became one of the happiest days of our lives.

And six months before the wedding, we began to prepare for pregnancy, because... Both of us really wanted to quickly direct our great love to someone else.

We approached the matter with all seriousness, underwent the necessary examinations, visited the necessary doctors and got the go-ahead!

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We celebrated the wedding, flew off on our honeymoon and... The three of us have already returned from there!

Happiness knew no bounds

I simply enjoyed my pregnancy, I even enjoyed morning sickness - after all, this was indisputable proof that a miracle lives inside me!

I easily passed 9 months and gave birth to a wonderful, healthy son. True, not by myself, as I was determined to do until the last moment, but with the help of a CS, but spinal anesthesia somehow compensated for the fact that I could not give birth on my own, because I heard everything and saw my baby right away, still in the operating room.

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Everything was wonderful, the stitches healed quickly, we were sent home in due time and we began to enjoy this incredible status - parents.

It's time to repeat

A year passed and we began to think that it would be nice to repeat what worked so well. I myself went to the doctor, passed the required minimum tests and received the go-ahead.

Time passed, pregnancy did not occur. This alarmed us a little, but I chalked it all up to the fact that we were still actively breastfeeding and we were missing something hormonally.

They stopped breastfeeding when the child was 1 year and 7 months old. More time passed, pregnancy did not occur.

I changed gynecologist and again had everything, absolutely everything, necessary tests done. I sent my husband to the doctor, and he also heroically passed all the necessary tests.

There were some non-critical deviations. All the doctor's recommendations were followed. The tests have been retaken. Improved. We tried our best.

I start a new cycle and somehow unexpectedly, just on the 9th day of the cycle, my chest starts to hurt, well, just like usual after ovulation.

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This alarmed me, I thought it was a hormonal imbalance. But after I put the baby to bed, I decided to take a pregnancy test...

The test drew a beautiful second stripe

I'll go straight to my husband he was happy, but for some reason I wasn’t…

And only one thought was spinning in my head:

It can’t be like this, it’s not normal, because my period just ended, if only it wasn’t ectopic!

We decided not to tell anyone until we were sure that the pregnancy was normal. I myself tried to believe it so much that, in spite of everything, I went in for a planned operation with my son.

In parallel with preparing for hospitalization with the child, I regularly took tests for hCG, it grew slowly, not as expected, which only confirmed my doubts.

I went for an ultrasound twice a week, we persistently looked for the fertilized egg, the gynecologist also immediately suggested a tubal pregnancy, but time passed, nothing hurt me, there was nothing in the uterus, hCG, although slowly, grew. Hope was fading before our eyes. But I hoped and believed in a miracle.

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No miracle happened

From the children's hospital I “moved” to the gynecology department, where my right tube was removed.

To say it was a shock is an understatement. It was a shock for everyone, no one knew.

My mother had to be asked to go to the hospital with her child, and I probably stole several years of her life because she was very worried.

And I really wanted to cry and cried, but everyone calmed me down. I remember, immediately after the operation, I told my husband that I no longer wanted any pregnancy, that We have a son and this is wonderful; many people do not have such happiness.

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Several more days passed. I calmed down, the consequences of the operation somehow began to go away, the doctor said that the second tube was just perfect, and after the CS everything was very good, and I said:

As long as I have at least some chance to give birth, I will go to the end! In the end, there is only one pipe left, if something happens, then for the last time there will be nothing more to remove

And how I looked into the water

As soon as we were allowed to get pregnant, we slowly got down to business. One morning I woke up with pain in my left side, which radiated insanely into my left leg, so much so that I could not walk.

I was lying down. Then I became scared and decided to go and give myself up to the hospital. At the hospital on duty they didn’t tell me anything except that “Oh, you have a CS and laparoscopy, these could be adhesions.”

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After two hours of sitting in the hospital, the sight of her seemed to make me feel better, if only I didn’t have to lie in it, and we went. But not home, but to the children's hospital - the child complained of ear pain, and after we started going to the kindergarten, he had otitis media very often.

And it just so happened that on the way to the children’s hospital we have a maternity hospital, and with it a perinatal center, where, in general, I decided to go just in case.

They didn't let me out of there anymore

The second tubal pregnancy was a complete surprise. After the first one, only six months passed. Nothing could have happened so quickly! After all, we couldn’t get pregnant for so long before.

How the doctor in the emergency room scolded me, by the way, the same one who removed my first tube and said that everything was fine with the remaining one.

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How I cried, how I could not sleep the whole night before the operation, how I regretted that we had rushed, how I scolded myself for my irresponsibility, how sorry I was that I would not be able to give birth to my child a brother or sister, as I was scary.

This morning my left tube was removed and for some reason they sent me to intensive care until the next morning (the first time I was transferred to a ward almost immediately). I really asked the nurse to call my mom, who was going crazy.

I felt better than after the first operation and by the evening I could already walk on my own. And at night I had a lot of time to feel sorry for myself and cry.

The first year it was very difficult for me to hear good news about someone’s pregnancy, to see expectant mothers, to learn that someone gave birth. It was really hard for me; every time I heard such news, something tightened inside me.

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I just ran to the child, hugged him and thanked God that we have a son, healthy, dear and so beloved.

And to this day I say every day: “Lord, thank you for my son!” and I ask why he sent me these tests, but I still can’t understand why.

Now I am again sincerely happy about all the pregnant women I know, newly baked mothers, I love squeezing babies, I just smile when I see pregnant girls on the street, thinking about what happiness awaits them ahead.

Apparently, in order to let go of this pain, you need to fully accept and understand it.

Life is not over, and my story of infertility is just beginning, because there are still many ways to become a mother again...